As President Trump moves to fulfill his campaign promises, including Department of Veterans Affairs reforms, Secretary Shulkin and VA’s senior leadership are continuing VA’s business transformation efforts aimed at maximizing efficiency, embracing innovation and, most importantly, providing our nation’s heroes with the superior quality healthcare and services they have earned. Secretary Shulkin has clarified a recent series of executive orders by reiterating there are no plans to privatize VA, but the department will move forward with a hybrid approach combining the best of VA’s capabilities with the best of the private sector. According to the Secretary, the VA will achieve this transformation by implementing “an integrated system of care” in which expertise and systems developed over years by the VA will be amalgamated with industry-leading services from the private sector.
However, an integrated system of care is no small feat for any organization, especially one with a mission as unique and complex as that of the Department of Veterans Affairs. To maximize the immediate impact on our nation’s veterans, any viable interoperability solution must seamlessly incorporate healthcare and benefits data from private industry into the applications utilized by VA clinicians and benefits administrators. So, how should the VA approach this transformation to accomplish a truly integrated system of care? The specific steps may be as unique and varied as VA’s mission, but Ellumen’s industry-leading Agile systems integration experience demonstrates Fast Healthcare Interoperability Resources (FHIR) technology is a viable solution for integrating complex, large-scale systems of care across a wide spectrum of interoperability use cases.
Adaptr™ is Ellumen’s Commercial off the Shelf (COTS) product which includes lightweight FHIR services that can be deployed quickly and tailored to most organization’s interoperability requirements, making integration an attainable and cost effective proposition. Within FHIR, each resource represents a capability to exchange a specific data element such as a medication, allergy intolerance or diagnostic report. The granular nature of the standard allows organizations to choose the precise patient data for their business needs and does not preclude the exchange of any data based on the absence of a few specific data elements. FHIR resources also extend beyond the clinical aspects of patient care and include a means to exchange data on payments, benefits and eligibility as well. With all the benefits of FHIR, could it be the solution to the VA’s integrated system of care goal?
Indeed, it can and, in some respects, it already is. Deployed in September 2016, Ellumen’s FHIR service, which leverages aspects of Ellumen’s Adaptr product, is providing VA VistA users across the enterprise with DoD clinical data. In use nationwide by over 100 thousand VA clinicians and benefits administrators, Ellumen’s industry-leading interoperability solution has serviced over 4.4 million queries for DoD clinical data, seamlessly integrating the results into the VA users native VistA systems. But this success is only the beginning of what FHIR could mean for interoperability at the VA. At HIMSS 2017, Ellumen showed how FHIR can be utilized to integrate data from commercial Electronic Health Records and COTS products into the VA’s VistA system with a demonstration that leveraged Cerner’s test FHIR service. Further enhancements of Ellumen’s Adaptr product have expanded FHIR capabilities to include applications in mobile and cloud based technologies which make our FHIR solutions even more flexible and attainable for any organization or interoperability challenge.
As the demand for integration with private partners continues to expand at the VA, FHIR is the logical tool to bridge the gap between the VA and private sector. With FHIR technology already proven and operational at VA, further enhancements to the use of FHIR are essential to rapidly and efficiently creating an integrated system of care that meets the immediate demand of the department and the veteran population. Allowing the VA to capitalize on the best of the private sector to support Veteran’s care, FHIR will light the way to business transformation at VA.
Adaptr is a trademark of Ellumen, Inc. HL7, and FHIR are registered trademarks of Health Level Seven International. Reg. U.S. Pat & TM Off.